Individual
CARISSA RENAE LUKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
903 N 7TH ST, VINCENNES, IN 47591-3107
(812) 316-0707
(812) 316-0702
Mailing address
429 PERRY ST, VINCENNES, IN 47591-2127
(812) 494-2920
(812) 494-2924
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004665A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201193500
—
IN
01
—
71004665A
LICENSE
IN
Enumeration date
10/03/2013
Last updated
03/01/2018
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